Department of Neurosurgery, University of Vermont, Burlington, VT, USA.
J Neurosurg. 2012 Apr;116(4):743-8. doi: 10.3171/2011.12.JNS11417. Epub 2012 Jan 6.
Ancient Egyptians were pioneers in many fields, including medicine and surgery. Our modern knowledge of anatomy, pathology, and surgical techniques stems from discoveries and observations made by Egyptian physicians and embalmers. In the realm of neurosurgery, ancient Egyptians were the first to elucidate cerebral and cranial anatomy, the first to describe evidence for the role of the spinal cord in the transmission of information from the brain to the extremities, and the first to invent surgical techniques such as trepanning and stitching. In addition, the transnasal approach to skull base and intracranial structures was first devised by Egyptian embalmers to excerebrate the cranial vault during mummification. In this historical vignette, the authors examine paleoradiological and other evidence from ancient Egyptian skulls and mummies of all periods, from the Old Kingdom to Greco-Roman Egypt, to shed light on the development of transnasal surgery in this ancient civilization. The authors confirm earlier observations concerning the laterality of this technique, suggesting that ancient Egyptian excerebration techniques penetrated the skull base mostly on the left side. They also suggest that the original technique used to access the skull base in ancient Egypt was a transethmoidal one, which later evolved to follow a transsphenoidal route similar to the one used today to gain access to pituitary lesions.
古埃及人在许多领域都是先驱者，包括医学和外科。我们现在对解剖学、病理学和外科技术的了解，源于埃及医生和防腐师的发现和观察。在神经外科学领域，古埃及人首先阐明了大脑和颅骨的解剖结构，首次描述了证据表明脊髓在大脑向四肢传递信息中的作用，并且是第一个发明了钻孔和缝合等外科技术的人。此外，埃及防腐师在木乃伊制作过程中，通过经鼻入路到达颅底和颅内结构，这是首次设计的方法。在这篇历史特写中，作者检查了从古王国到希腊罗马埃及时期的所有时期的古埃及头骨和木乃伊的古放射性和其他证据，以阐明这种古老文明中经鼻手术的发展。作者证实了早期关于该技术的偏侧性的观察结果，表明古埃及的去颅盖技术主要是在左侧穿透颅底。他们还提出，古埃及人最初用于进入颅底的技术是经筛窦的，后来演变为类似于今天用于治疗垂体病变的经蝶窦入路。
